The Process of Interpretation

Abstract

Interpretations are efforts by the therapist to connect conscious (or preconscious) feelings, thoughts, and behaviors (e.g., symptoms) to the unconscious materials that gave rise to them. Interpretations may consist of therapist observations or the presentation of a hypothesis that goes beyond what the patient already knows. Interpretations are often considered to be the epitome of the expressive therapy approach and, when done well, have been empirically linked to a positive outcome. Unfortunately, many beginning therapists are reluctant to use interpretations due to their complexity. Therefore, this chapter describes a clear, six-step procedure for generating psychodynamic interpretations and presenting them to patients. It also includes a list of questions for therapists to answer as they organize patient material. The chapter concludes with a lengthy clinical vignette following the six-step process and a discussion of the potential risks and rewards of interpretation.